<!--
To change this template, choose Tools | Templates
and open the template in the editor.
-->
<!DOCTYPE html>
<html>
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
        <title></title>
         <link rel="stylesheet" type="text/css" href="../style/styles.css"/> 
    </head>
    <body>
       <div id="whole">
            <br/>
          <?php include 'header.php'; ?>
          
          <?php include 'menu.php'; ?>
            
            
  <div id="content">
            
         <div id="form" style="margin: 300px 0 0 0;">		
			 
  <!--           <fieldset>
          <legend style="color: green; font-weight: 100;">Document Information</legend>
        
      <div class="documentinfo" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
  
          <label for="document">Document:</label><input type="text" name="document">
          <label for="docunumber">Document Number:*</label><input type="text" name="docunumber">
          <label for="docudate">Document Date:*</label><input type="text" name="docudate"><br/>
          
          <label for="docuref">Document Ref </label><input type="text" name="docuref">
          <label for="docuref">Document Ref No. </label><input type="text" name="docurefno"><br/>
          <label for="docurefdate">Document Ref Date</label><input type="text" name="docurefdate">
          
          <label for="docuimage">Document Image:</label><input type="file" id="c" name="docuimage">
     
      </div>
        
             </fieldset> 
             <br/>-->
             
         
      <div class="borrowernickname" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;">
  
            <fieldset>
          <legend style="color: green; font-weight: 100;">Borrower's Nickname</legend>
        
          <label for="borrowerfullname">Borrower Full Name:</label><input type="text" name="borrowerfullname">
          <label for="nickname">Nickname:</label><input type="text" name="nickname">
            </fieldset>
          </div><br/>
         
      <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
      
	     <fieldset>
          <legend style="color: green; font-weight: 100;">Current Address Description</legend>
        
          <label for="floorare">Floor Area (sq.meters)</label><input id="a" name="floorarea">
          <label for="landarea">Land Area (sq.meters)</label><input id="b" name="landarea"> 
          <label for="businestability">Business Stability</label>
          <select>
              <option>Please Select</option>
              <option>Owned</option>
              <option>Mortgage</option>
              <option>Renting</option>
              <option>Living with Parents</option>
              
          </select><br/>
          
          <label for="model">Model</label>
          <select>
              <option>Please Select</option>
              <option>Single Detach</option>
              <option>Row House</option>
              <option>Two Story</option>
              <option>Duplex</option>
              
          </select>
          
          <label for="make" style="margin: 0 40px;">Make </label>
          <select>
              <option>Please Select</option>
              <option>Concrete</option>
              <option>Wood</option>
              <option>Renting</option>
              <option>Steel</option>
              <option>Nipa</option>
              <option>Fenced</option>
              <option>Garage</option>
              
          </select>
          
          <label for="land">Land </label>
          <select>
              <option>Owned</option>
              <option>Mortgage</option>
              <option>Renting</option>
              <option>Government</option>
              
          </select><br/><br/>
          <b>If renting:</b><br/>
          <label for="namelandlord">Name of Landlord</label><input type="text" name="namelandlord">
          <label for="monthlyrental">Monthly Rental</label><input type="text" name="monthlyrental">
          <label for="landlordadd">Landlord Address</label><input type="text" name="landlordadd">
          <label for="phoneno">Phone No.</label><input type="text" name="phoneno">
             </fieldset>
      </div><br/> 
                
         <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
<fieldset>
          <legend style="color: green; font-weight: 100;">Place of Business Description</legend>
            
                   <b>Place of Business Description</b><br/>
  
                    <label for="businessname">Business Name</label><input type="text" name="businessname"><br/>
                    <label for="businesstype">Business Type</label><input type="text" name="businesstype"><br/>
                    <label for="floorarea">Floor Area</label><input type="text" name="floorarea">sq. meter<br/> 
                    <label for="landarea">Land Area</label><input type="text" name="landarea">sq. meter <br/>
                    <label for="businesstability">Business Stability</label>
                    <select>
                        <option>Please Select</option>
                        <option>Owned</option>
                        <option>Mortgage</option>
                        <option>Renting</option>
                        <option>Living with Parents</option>
                    </select><br/>
                    
                    <label for="model">Model</label>
                    <select>
                        <option>Please Select</option>
                        <option>Single Detach</option>
                        <option>Row House</option>
                        <option>Two Story</option>
                        <option>Duplex</option>
                    </select><br/>
                   
                     <label for="make">Make</label>
                    <select>
                        <option>Please Select</option>
                        <option>Concrete</option>
                        <option>Wood</option>
                        <option>Renting</option>
                        <option>Steel</option>
                        <option>Nipa</option>
                        <option>Fenced</option>
                        <option>Garage</option>
                    </select><br/>
                   
                     <label for="land">Land</label>
                    <select>
                        <option>Please Select</option>
                        <option>Owned</option>
                        <option>Mortgage</option>
                        <option>Renting</option>
                        <option>Government</option>
                    </select><br/>
                    
                    <label for="dailyavesales">Daily Ave. Sales</label><input type="text" name="dailyavesales"><br/>
                    <b>If renting:</b><br/>
                    <label for="namelandlord">Name of Landlord</label><input type="text" name="namelandlord"><br/>
                    <label for="monthrental">Monthly Rental</label><input type="text" name="monthrental"><br/>
                     <label for="landlordadd">Landlord Address</label><input type="text" name="landlordadd"><br/>
                     
                     <label for="phoneno">Phone No.</label><input type="text" name="phoneno"><br/>
                     
          </fieldset>           
           </div>
          
             
                    
          <div class="vehiclesowned" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
             <fieldset>
          <legend style="color: green; font-weight: 100;">Vehicles Owned</legend>
    
                   <b>Vehicles Owned</b><br/>
  
    <table border="0" id="tblvehicle" width="100%">
                        <tr>
                            <td>No. Of Units<label id="creditform_"></label></td>
                            <td><input type="text" name="noofunitsvehicle" value="" id="noofunitsvehicle" style="width: 30px;"/></td>
                        </tr>
                        <tr>

                            <td></td>
                            <td>Type<label id="creditform_"></label></td>
                            <td>Make<label id="creditform_"></label></td>
                            <td>Model<label id="creditform_"></label></td>
                            </tr>
                            <tr id="tobeclonedvehicle">
                                <td>1</td>

                                <td><input type="text" name="vtype" value="" id="typevehicle"/></td>
                            <td><input type="text" name="make" value="" id="makevehicle"/></td>
                            <td><input type="text" name="model" value="" id="modelvehicle"/></td>
                        </tr>
                    </table>
                    <input type="submit" value="Add More"/> 
             </fieldset>     
               </div>

                <div class="othersourceincome" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
             <fieldset>
          <legend style="color: green; font-weight: 100;">Others Sources of Income</legend>
    
          
       <table border="0" id="tblother" width="100%">
                        <tr>
                            <td></td>
                            <td></td>
                            <td>Employer/Business Name<label id="creditform_"></label></td>

                            <td>Address<label id="creditform_"></label></td>
                            <td>Position<label id="creditform_"></label></td>
                            <td>Income<label id="creditform_"></label></td>
                            </tr>
                            <tr id="tobeclonedother">
                                <td>1</td>
                                <td>

                                <select name="type" id="othersrctype">
    <option value="-1"
    >Please Select</option>
    <option value="Applicant">Applicant</option>
    <option value="Spouse">Spouse</option>
    <option value="Family">Family</option>


</select>

</td>
                            <td><input type="text" name="employer" value="" id="empbusname"/></td>
                            <td><input type="text" name="address" value="" id="otheraddress"/></td>
                            <td><input type="text" name="position" value="" id="otherposition"/></td>
                            <td><input type="text" name="income" value="" id="otherincome"/></td>
                        </tr>
                    </table>
          <input type="submit" value="Add More"/>
             </fieldset>     
               </div>
      
      
             <div class="educattain" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
             <fieldset>
   
          <legend style="color: green; font-weight: 100;">Educational Attainment</legend>
                   
              <table border="0" width="100%">
                    <tr>
                        <td><td>
                        <td>Degree</td>

                        <td>School</td>
                        <td>Year Graduated</td>
                    </tr>
                    <tr>
                        <td>Applicant<td>
                       
                        <td><input type="text" name="school" value="" id="appschool" style="width: 250px"/></td>

                        <td><input type="text" name="yeargraduated" value="" id="appyeargrad"/></td>
                    </tr>
                    <tr>
                        <td>Spouse<td>
                        <td><input type="text" name="spousedegree" value="" id="spousedegree" style="width: 250px"/></td>
                        <td><input type="text" name="spouseschool" value="" id="spouseschool" style="width: 250px"/></td>
                        <td><input type="text" name="spouseyeargraduated" value="" id="spouseyeargrad"/></td>
                    </tr>

                </table>
             </fieldset>     
               </div> <!---end of educ attain --->
               
   <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
    <fieldset>
          <legend style="color: green; font-weight: 100;">Previous Home Address</legend>
            
                   <b>Place of Business Description</b><br/>
  
<table border="0" width="100%">
                    <tr>

                        <td>Street Address<label id="creditform_"></label></td>
                        <td>Barangay<label id="creditform_"></label></td>
                        <td>Municipality/City<label id="creditform_"></label></td>
                        <td>Province<label id="creditform_"></label></td>
                        <td>Postal Code<label id="creditform_"></label></td>

                        </tr>

                        <tr>
                            <td>
                            <input type="text" name="previousstreetaddress" value="" id="prevaddstreet"/>
                        </td>
                        <td>
                            <input type="text" name="previousbarangay" value="" id="prevaddbrgy"/>
                        </td>
                        <td>
                            <input type="text" name="previouscityormunicipality" value="" id="prevaddcitymuni"/>

                        </td>
                        <td>
                            <input type="text" name="previousprovince" value="" id="prevaddprovince"/>
                        </td>
                        <td>
                            <input type="text" name="previouspostalcode" value="" id="prevaddpostalcode"/>
                        </td>

                    </tr>

                    <tr>
                        <td>Years of Stay<label id="creditform_"></label>
                            <select name="previouslengthofstayinyears" id="previouslengthofstayinyears" style="width: 40px;">
    <option value="-1"
    >Please Select</option>
    <option value="0">0</option>
    <option value="1">1</option>
    <option value="2">2</option>

    <option value="3">3</option>
    <option value="4">4</option>
    <option value="5">5</option>
    <option value="6">6</option>
    <option value="7">7</option>
    <option value="8">8</option>

    <option value="9">9</option>
    <option value="10">10</option>


</select>


                        <td>Months of Stay<label id="creditform_"></label>
                            <select name="previouslengthofstayinmonths" id="creditform_previouslengthofstayinmonths" style="width: 40px;">
    <option value="-1"
    >Please Select</option>

    <option value="1">1</option>
    <option value="2">2</option>
    <option value="3">3</option>
    <option value="4">4</option>
    <option value="5">5</option>
    <option value="6">6</option>

    <option value="7">7</option>
    <option value="8">8</option>
    <option value="9">9</option>
    <option value="10">10</option>
    <option value="11">11</option>
    <option value="12">12</option>


</select>

                        </td>
                    </tr>


                </table>
      
                    </fieldset>     
               </div>
               
               <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
    <fieldset>
          <legend style="color: green; font-weight: 100;">Parents Address
</legend>
            
                  
   <table border="0" width="100%">
                    <tr>
                        <td>Street Address<label id="creditform_"></label></td>
                        <td>Barangay<label id="creditform_"></label></td>
                        <td>Municipality/City<label id="creditform_"></label></td>

                        <td>Province<label id="creditform_"></label></td>
                        <td>Postal Code<label id="creditform_"></label></td>
                        </tr>
                        <tr>
                            <td>
                            <input type="text" name="parentsstreetaddress" value="" id="parentaddstreet"/>
                        </td>
                        <td>

                            <input type="text" name="parentsbarangay" value="" id="parentaddbrgy"/>
                        </td>
                        <td>
                            <input type="text" name="parentscityormunicipality" value="" id="parentaddcitymuni"/>
                        </td>
                        <td>
                            <input type="text" name="parentsprovince" value="" id="parentaddprovince"/>
                        </td>
                        <td>

                            <input type="text" name="parentspostalcode" value="" id="parentpostalcode"/>
                        </td>

                    </tr>
                    <tr>
                        <td>Years of Stay<label id="creditform_"></label>
                            <select name="parentslengthofstayinyear" id="creditform_parentslengthofstayinyear" style="width: 40px;">
    <option value="-1"
    >Please Select</option>

    <option value="0">0</option>
    <option value="1">1</option>
    <option value="2">2</option>
    <option value="3">3</option>
    <option value="4">4</option>
    <option value="5">5</option>

    <option value="6">6</option>
    <option value="7">7</option>
    <option value="8">8</option>
    <option value="9">9</option>
    <option value="10">10</option>


</select>

                        </td>
                        <td>Months of Stay<label id="creditform_"></label>
                            <select name="parentslengthofstayinmonths" id="creditform_parentslengthofstayinmonths" style="width: 40px;">
    <option value="-1"
    >Please Select</option>
    <option value="1">1</option>
    <option value="2">2</option>

    <option value="3">3</option>
    <option value="4">4</option>
    <option value="5">5</option>
    <option value="6">6</option>
    <option value="7">7</option>
    <option value="8">8</option>

    <option value="9">9</option>
    <option value="10">10</option>
    <option value="11">11</option>
    <option value="12">12</option>


</select>

                        </td>

                    </tr>
                </table>
    
    </fieldset>     
     </div>
               
   <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Parents Address</legend>
          
          
           <table border="0" width="100%">
<!-- width="100%"-->
                    <tr>
                        <td></td>
                        <td>First Name<label id="creditform_"></label></td>
                        <td>Middle Name<label id="creditform_"></label></td>
                        <td>Last Name<label id="creditform_"></label></td>
                        <td>Employer<label id="creditform_"></label></td>
                        <td>Position<label id="creditform_"></label></td>

<!--                       <td>Age<label id="creditform_"></label></td>-->
                        </tr>
                        <tr>
                            <td>Father<label id="creditform_"></label></td>
                        <td><input type="text" name="fatherfirstname" value="" id="fatherlastname"/></td>
                        <td><input type="text" name="fathermiddlename" value="" id="fathermi"/></td>
                        <td><input type="text" name="fatherlastname" value="" id="fatherfirstname"/></td>
                        <td><input type="text" name="fatheremployer" value="" id="fatheremp"/></td>

                        <td><input type="text" name="fatherposition" value="" id="fatherposition"/></td>
<!--                        <td><input type="text" name="fatherage" value="" id="fatherage" style="width: 30px;"/></td>-->
                    </tr>
                    <tr>
                        <td>Mother<label id="creditform_"></label></td>
                        <td><input type="text" name="motherfirstname" value="" id="motherfirstname"/></td>
                        <td><input type="text" name="mothermiddlename" value="" id="mothermi"/></td>
                        <td><input type="text" name="motherlastname" value="" id="motherlastname"/></td>

                        <td><input type="text" name="motheremployer" value="" id="motheremp"/></td>
                        <td><input type="text" name="motherposition" value="" id="motherposition"/></td>
<!--                        <td><input type="text" name="motherage" value="" id="motherage" style="width: 30px;"/></td>-->
                    </tr>
                </table>
          
  </fieldset>     
     </div>
               
                <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Parents-in-Law's Address</legend>
 
          <table border="0" width="100%">
                    <tr>
                        <td>Street Address<label id="creditform_"></label></td>
                        <td>Barangay<label id="creditform_"></label></td>
                        <td>Municipality/City<label id="creditform_"></label></td>
                        <td>Province<label id="creditform_"></label></td>

                        <td>Postal Code<label id="creditform_"></label></td>
                        </tr>
                        <tr>
                            <td>
                            <input type="text" name="parentsinlawstreetaddress" value="" id="parentinlawaddno"/>
                        </td>
                        <td>
                            <input type="text" name="parentsinlawbarangay" value="" id="parentinlawaddbrgy"/>

                        </td>
                        <td>
                            <input type="text" name="parentsinlawcityormunicipality" value="" id="parentinlawaddcitymuni"/>
                        </td>
                        <td>
                            <input type="text" name="parentsinlawprovince" value="" id="parentinlawaddprovince"/>
                        </td>
                        <td>
                            <input type="text" name="parentsinlawpostalcode" value="" id="parentinlawaddprovince"/>

                        </td>

                    </tr>
                    <tr>
                        <td>Years of Stay<label id="creditform_"></label>
                            <select name="parentsinlawlengthofstayinyears" id="creditform_parentsinlawlengthofstayinyears" style="width: 40px;">
    <option value="-1"
    >Please Select </option>
    <option value="0">0</option>

    <option value="1">1</option>
    <option value="2">2</option>
    <option value="3">3</option>
    <option value="4">4</option>
    <option value="5">5</option>
    <option value="6">6</option>

    <option value="7">7</option>
    <option value="8">8</option>
    <option value="9">9</option>
    <option value="10">10</option>


</select>

                        </td>

                        <td>Months of Stay<label id="creditform_"></label>
                            <select name="parentsinlawlengthofstayinmonths" id="creditform_parentsinlawlengthofstayinmonths" style="width: 40px;">
    <option value="-1"
    >Please Select</option>
    <option value="1">1</option>
    <option value="2">2</option>
    <option value="3">3</option>

    <option value="4">4</option>
    <option value="5">5</option>
    <option value="6">6</option>
    <option value="7">7</option>
    <option value="8">8</option>
    <option value="9">9</option>

    <option value="10">10</option>
    <option value="11">11</option>
    <option value="12">12</option>


</select>

                        </td>
                    </tr>

                </table>
  
  </fieldset>     
     </div>
               
                <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Parents-in-Law's Information</legend>
                <table border="0" width="100%">
                    <tr>

                        <td></td>
                        <td>First Name<label id="creditform_"></label></td>
                        <td>Middle Name<label id="creditform_"></label></td>
                        <td>Last Name<label id="creditform_"></label></td>
                        <td>Employer<label id="creditform_"></label></td>
                        <td>Position<label id="creditform_"></label></td>

<!--                        <td>Age<label id="creditform_"></label></td>-->
                        </tr>
                        <tr>
                            <td>Father<label id="creditform_"></label></td>
                        <td><input type="text" name="fatherinlawfirstname" value="" id="fatherinlawfirstname"/></td>
                        <td><input type="text" name="fatherinlawmiddlename" value="" id="fatherinlawmi"/></td>
                        <td><input type="text" name="fatherinlawlastname" value="" id="fatherinlawlastname"/></td>
                        <td><input type="text" name="fatherinlawemployer" value="" id="fatherinlawemp"/></td>

                        <td><input type="text" name="fatherinlawposition" value="" id="fatherinlawposition"/></td>
<!--                        <td><input type="text" name="fatherinlawage" value="" id="fatherinlawage" size="2"/></td>-->
                    </tr>
                    <tr>
                        <td>Mother<label id="creditform_"></label></td>
                        <td><input type="text" name="motherinlawfirstname" value="" id="motherfirstname"/></td>
                        <td><input type="text" name="motherinlawmiddlename" value="" id="mothermi"/></td>
                        <td><input type="text" name="motherinlawlastname" value="" id="motherlastname"/></td>

                        <td><input type="text" name="motherinlawemployer" value="" id="motheremp"/></td>
                        <td><input type="text" name="motherinlawposition" value="" id="motherposition"/></td>
<!--                        <td><input type="text" name="motherinlawage" value="" id="motherage" size="2"/></td>-->
                    </tr>
                </table>
          
            </fieldset>     
     </div>
               
                      <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Personal and Real Properties Owned</legend>
          
<table border="0" id="tblpersonal" width="100%">
                        <tr>
                            <td></td>
                            <td>Description</td>
                            <td>Nature</td>
                            <td>Location</td>

                            <td>Value</td>
                        </tr>
                        <tr id="tobeclonedpersonal">
                            <td>1</td>
                            <td><input type="text" name="description" value="" id="prpdescription"/></td>
                            <td><input type="text" name="nature" value="" id="prpnature"/></td>
                            <td><input type="text" name="location" value="" id="prplocation"/></td>
                            <td><input type="text" name="value" value="" id="value6"/></td>

                        </tr>
                    </table>
          <input type="submit" value="Add More"/>
  </fieldset>     
     </div>
               
   <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Savings, Time Deposit and Other Notes Receivables</legend>
                      <table border="0" id="tblsavings" width="100%">
                        <tr>
                            <td></td>
                            <td>Bank/Institution</td>
                            <td>Type</td>
                            <td>Account Number</td>
                            <td>Amount</td>

                        </tr>
                        <tr id="tobeclonedsavings">
                            <td>1</td>
                            <td><input type="text" name="bank" value="" id="stobankinstitution"/></td>
                            <td><input type="text" name="stotype" value="" id="stotype"/></td>
                            <td><input type="text" name="accountno" value="" id="stoaccountno"/></td>
                            <td> <input type="text" name="amount" value="" id="stoamount"/></td>
                        </tr>

                    </table>
          
          <input type="submit" value="Add More"/>
  </fieldset>     
     </div>
               
               
                <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Savings, Time Deposit and Other Notes Receivables</legend>
  
 
           <table border="0" width="100%">

                    <tr>
                        <td colspan="6" style="font-size: 14px; font-weight: bold;">Reputation<label id="creditform_"></label></td>
                            <td>
                                <div class="inputContainer">
<input type="checkbox" name="reputation" value="Good moral character" id="creditform_reputation"/>

<input type="hidden" id="__checkbox_creditform_reputation" name="__checkbox_reputation" value="Good moral character" /> Good moral character<label id="creditform_"></label><br />

<input type="checkbox" name="reputation" value="Notorious character" id="creditform_reputation"/>

<input type="hidden" id="__checkbox_creditform_reputation" name="__checkbox_reputation" value="Notorious character" /> Notorious character<label id="creditform_"></label><br />

<input type="checkbox" name="reputation" value="Heavily indebted" id="creditform_reputation"/>
<input type="hidden" id="__checkbox_creditform_reputation" name="__checkbox_reputation" value="Heavily indebted" /> Heavily indebted<label id="creditform_"></label><br />

<input type="checkbox" name="reputation" value="Frequented by collectors" id="creditform_reputation" 
       />
<input type="hidden" id="__checkbox_creditform_reputation" name="__checkbox_reputation" value="Frequented by collectors" /> Frequented by collectors<label id="creditform_"></label><br />

<input type="checkbox" name="reputation" value="Extravagant" id="creditform_reputation" 
       />

<input type="hidden" id="__checkbox_creditform_reputation" name="__checkbox_reputation" value="Extravagant" /> Extravagant<label id="creditform_"></label><br />

<input type="checkbox" name="reputation" value="Gambler" id="creditform_reputation" />

<input type="hidden" id="__checkbox_creditform_reputation" name="__checkbox_reputation" value="Gambler" /> Gambler<label id="creditform_"></label><br />

<input type="checkbox" name="reputation" value="Adulterous" id="creditform_reputation" />

<input type="hidden" id="__checkbox_creditform_reputation" name="__checkbox_reputation" value="Adulterous" /> Adulterous<label id="creditform_"></label><br />

<input type="checkbox" name="reputation" value="Separated" id="creditform_reputation" />

<input type="hidden" id="__checkbox_creditform_reputation" name="__checkbox_reputation" value="Separated" /> Separated<label id="creditform_"></label>
                                </div>
                            </td>

                        </tr>
                        <tr>
                            <td colspan="6" style="font-size: 14px; font-weight: bold;">Residence Confirmation<label id="creditform_"></label></td>
                            <td>
                            Residence Confirmation<label id="creditform_"></label>
                                <div class="inputContainer">
                                <select name="presentaddressstatus" id="rescon" class="validate[required]">
    <option value="-1"
    >Please Select</option>

    <option value="Owned">Owned</option>
    <option value="Mortgage">Mortgage</option>
    <option value="Living w/ Parents">Living w/ Parents</option>
    <option value="Free">Free</option>


</select>

                            </div>

                            <br />
                            Length of Stay<label id="creditform_"></label>
                            <select name="presentaddresslengthofstayinyears" id="creditform_presentaddresslengthofstayinyears" class="validate[required]" style="width: 40px;">
    <option value="-1"
    >Please Select</option>
    <option value="0">0</option>
    <option value="1">1</option>
    <option value="2">2</option>

    <option value="3">3</option>
    <option value="4">4</option>
    <option value="5">5</option>
    <option value="6">6</option>
    <option value="7">7</option>
    <option value="8">8</option>

    <option value="9">9</option>
    <option value="10">10</option>


</select>

                            Months of Stay<label id="creditform_"></label>
                                <div class="inputContainer">
                                <select name="presentaddresslengthofstayinmonths" id="creditform_presentaddresslengthofstayinmonths" class="validate[required]" style="width: 40px;">

    <option value="-1"
    >Please Select</option>
    <option value="1">1</option>
    <option value="2">2</option>
    <option value="3">3</option>
    <option value="4">4</option>
    <option value="5">5</option>

    <option value="6">6</option>
    <option value="7">7</option>
    <option value="8">8</option>
    <option value="9">9</option>
    <option value="10">10</option>
    <option value="11">11</option>

    <option value="12">12</option>


</select>

                            </div>
                        </td>
                    </tr>
                    <tr>
                        <td colspan="6" style="font-size: 14px; font-weight: bold;">Source of Income<label id="creditform_"></label></td>

                            <td>
                            <input type="checkbox" name="sourceofincome" value="Employment" id="creditform_sourceofincome"/>
<input type="hidden" id="__checkbox_creditform_sourceofincome" name="__checkbox_sourceofincome" value="Employment" /> Employment<label id="creditform_"></label><br />
                            <input type="checkbox" name="sourceofincome" value="Business" id="creditform_sourceofincome"/>
<input type="hidden" id="__checkbox_creditform_sourceofincome" name="__checkbox_sourceofincome" value="Business" /> Business<label id="creditform_"></label><br />
                            <input type="checkbox" name="sourceofincome" value="Overseas Remittance" id="creditform_sourceofincome"/>
<input type="hidden" id="__checkbox_creditform_sourceofincome" name="__checkbox_sourceofincome" value="Overseas Remittance" /> Overseas Remittance<label id="creditform_"></label><br />

                            <input type="checkbox" name="sourceofincome" value="Pension" id="creditform_sourceofincome"/>
<input type="hidden" id="__checkbox_creditform_sourceofincome" name="__checkbox_sourceofincome" value="Pension" /> Pension<label id="creditform_"></label>
                            </td>
                        </tr>
                    </table>
          
           </fieldset>     
     </div>
               
               
 <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Savings, Time Deposit and Other Notes Receivables</legend>
  
          <table border="0" id="tblinformants" width="100%">
                        <tr>
                            <td></td>
                            <td>First Name</td>
                            <td>Middle Name</td>

                            <td>Last Name</td>
                            <td>Relationship to Borrower</td>
                            <td>Address</td>
                            <td>Length of Relationship</td>
                        </tr>
                        <tr id="tobeclonedinformants">
                            <td>1</td>

                            <td><input type="text" name="ifirstname" value="" id="informant1firstname"/></td>
                            <td><input type="text" name="imiddlename" value="" id="informant1mi"/></td>
                            <td><input type="text" name="ilastname" value="" id="informant1lastname"/></td>
                            <td><input type="text" name="irelationshiptoborrower" value="" id="informant1rel"/></td>
                            <td><input type="text" name="iaddress" value="" id="informant1address"/></td>
                            <td><input type="text" name="ilengthofrelationshipinyears" value="" id="lengthofrelationshipinyears3"/></td>
                        </tr>
                    </table>
          <input type="submit" value="Add More"/>
           </fieldset>     
     </div>
 
 <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Documents Presented
</legend>
 
  <table border="0" id="tbldocs" width="100%">
                        <tr>
                            <td></td>

                        </tr>
                        <tr>
                            <td></td>
                            <td>Documents Type<label id="creditform_"></label></td>
                            <td>Documents No.<label id="creditform_"></label></td>
                            <td>Type of Copy<label id="creditform_"></label></td>
                            </tr>

                            <tr id="tobecloneddocs">
                                <td>1</td>
                                <td><input type="text" name="documenttype" value="" id="documenttype"/></td>
                            <td><input type="text" name="documentno" value="" id="documentno"/></td>
                            <td>
                                <select name="copytype" id="documenttypecopy">
    <option value="-1"
    >Please Select</option>
    <option value="Original">Original</option>

    <option value="Photocopy">Photocopy</option>


</select>

                            </td>
                        </tr>
                    </table>
      <input type="submit" value="Add More"/>
      
  </fieldset>     
     </div>
  
 <div class="curaddadescrip" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Observations and Situational Analysis</legend>
 
           <table border="0" width="100%">
                    <tr>
                        <td>
                            Stocks Worth Description<label id="creditform_"></label><br/>

                            <textarea name="stocksworth" cols="45" rows="10" id="stocksworth"></textarea><br/>
                            Stocks Worth Amount<label id="creditform_"></label><br/>
                            <input type="text" name="stocksworthamount" value="" id="stocksworthamount"/>
                        </td>
                        <td>
                            Remarks<label id="creditform_"></label><br/>
                            <textarea name="remarks" cols="45" rows="10" id="osaremarks"></textarea><br/>

                            <input type="text" name="asdfasd" value="" id="creditform_asdfasd" style="visibility: hidden;"/>
                        </td>
                        <td>
                            Types of Collaterals<label id="creditform_"></label><br/>
                            <input type="checkbox" name="collateral" value="Appliance" id="creditform_collateral"/>
<input type="hidden" id="__checkbox_creditform_collateral" name="__checkbox_collateral" value="Appliance" /> Appliance<label id="creditform_"></label><br />
                            <input type="checkbox" name="collateral" value="Motor Vehicle" id="creditform_collateral"/>
<input type="hidden" id="__checkbox_creditform_collateral" name="__checkbox_collateral" value="Motor Vehicle" /> Motor Vehicle<label id="creditform_"></label><br />

                            <input type="checkbox" name="collateral" value="Passenger Tricycle" id="creditform_collateral"/>
<input type="hidden" id="__checkbox_creditform_collateral" name="__checkbox_collateral" value="Passenger Tricycle" /> Passenger Tricycle<label id="creditform_"></label><br />
                            <input type="checkbox" name="collateral" value="House and Lot" id="creditform_collateral"/>
<input type="hidden" id="__checkbox_creditform_collateral" name="__checkbox_collateral" value="House and Lot" /> House and Lot<label id="creditform_"></label><br />
                            <input type="checkbox" name="collateral" value="Land Title" id="creditform_collateral"/>
<input type="hidden" id="__checkbox_creditform_collateral" name="__checkbox_collateral" value="Land Title" /> Land Title<label id="creditform_"></label><br />
                            Others:<label id="creditform_"></label><input type="text" name="othertypecollateral" value="" id="othertypecollateral"/>

                            </td>
                        </tr>
                    </table>
          
          </fieldset>     
     </div>
  
 <div class="evalrecomdation" style="color: lightslategray; font-size: 12px; margin: 20px 0 0 0;" >
            
  <fieldset>
          <legend style="color: green; font-weight: 100;">Evaluation and Recommendations</legend>
 
                              <table border="0" width="100%">
                        <tr>
                            <td>
                            Credit Consultant<label id="creditform_"></label><br/>
                            <textarea name="creditconsultantrecommendation" cols="35" rows="10" id="ercreditcon"></textarea>
                        </td>

                        <td>

                            Branch Manager<label id="creditform_"></label><br/>
                            <textarea name="branchmanagerrecommendation" cols="35" rows="10" id="erbm"></textarea>
                        </td>

                        <td>
                            Area Manager<label id="creditform_"></label><br/>
                            <textarea name="areamanagerrecommendation" cols="35" rows="10" id="eram"></textarea>

                        </td>
                    </tr>
                </table>
          
          
  </fieldset>     
     </div>
               
               
        </div>
      
   </div>
            
              <?php include 'footer.php'; ?>
            
        </div>

    </body>
</html>
